STANDING STILL: WHY NORTH AMERICAN WORKERS ARE NOT INSISTING ON SEATS DESPITE KNOWN HEALTH BENEFITS

The Retreat of Labor

STANDING STILL: WHY NORTH AMERICAN WORKERS

ARE NOT INSISTING ON SEATS DESPITE

KNOWN HEALTH BENEFITS

Karen Messing, Sylvie Fortin, Geneviève Rail,and Maude Randoin

Prolonged standing is associated with health problems. Despite regulationsproviding for access to seats, most Québec (Canada) workers usually stand.Only one in six can sit at will. Standing service workers such as cashiers andsales personnel are often confined to a small area where sitting is theoreticallyfeasible. In many other countries, such workers have access to seats. Thisstudy asks why North American workers do not press for seats. In a quali-tative, exploratory approach, 30 young workers who usually work standingwere interviewed about their perceptions and experiences of prolongedstanding at work. All but one experienced discomfort associated with thisposture, and two-thirds reported that they had changed their lifestyle in someway as a result of their symptoms. However, their accounts of relationshipswith employers, health care personnel, and the health and safety systemsuggest that many environmental factors as well as attitudes toward work,employers, health, and the body contribute to maintaining the status quo.Workers describe problems with the image of a seated worker and thoughtthat asking for a seat would threaten their relationship with the employer.Personal comfort was considered an insufficient reason to challenge worksitedesign, attitudes, and organization.

Back pain associated with work is about twice as common among those whostand as among those who usually work sitting, even after controlling for age andlifting weights (1). Standing at work has also been associated with pain in thelower limbs (2, 3), varicose veins (4), chronic venous insufficiency (5), a poorerprognosis after diagnosis of coronary artery disease (6), and preterm births (7).

In Québec (Canada), 59 percent of the labor force report that they usuallywork in a standing position, and only one in six of these can sit down at will. The

International Journal of Health Services, Volume 35, Number 4, Pages 745–763, 2005

proportion of standing workers rises to 62 percent for men, 76 percent for workersearning less than $20,000 (Canadian dollars) a year, and 81 percent for workersaged 15 to 24 years. Among those who stand, 43 percent do not move around verymuch, most of them women (8). People who stand at work are likely to be of lowersocial class and have more difficult jobs (8), and the reasons for this are thereforeof interest to those studying relations between social class and health.

In principle, someone who is able to work standing in the same place for a longtime should be able to do the job sitting, with minimum rearrangement of the workstation. This is shown by the fact that, in many countries in Europe, as wellas in such developing countries as Thailand, Brazil, Costa Rica, and Morocco,supermarket cashiers, bank clerks, and sales personnel sit or have seats available(observations of the authors). In the Swedish working population aged 20 to 64years, only 19 percent of men and 15 percent of women work standing duringmore than one-tenth of the day (9).

In North America, however, the tradition is different. In 1989, a checkoutclerk who suffered from back pain asked for a seat under article 11.7.1 of theQuébec Regulation Respecting Industrial and Commercial Establishments, andher case was accepted by the appeals commission in 1991.1 Because the articlerequired that a seat should be supplied where the work process allowed it, thedecision should have led to the installation of seated work stations. However, morethan 15 years later, supermarket checkout clerks in Québec still have no seats,nor do many other service workers.

Although management experts have explored workers’ resistance to imposedchanges (10), little has been published on why workers do not push for changewhen it is in their interest. The present exploratory study considers why workersin Québec do not seem to exert much pressure to be allowed to sit, despite thediscomfort and health costs of their working posture. The study included thedisciplinary perspectives of the authors: ergonomics, movement education,sociology, and law.

METHODS

Thirty workers were recruited using the snowball method (11), initiated throughcontacts of members of the research team. Criteria for selection were that inter-viewees should speak French (the language of the interview) and that they shouldhave worked in a standing occupation for at least three months (with or withoutaccess to a seat). They were recruited in the urban area of Montréal (Québec). Amix of men and women and a diversity of work situations were sought, althoughwe were particularly interested in those who, like supermarket checkout clerks,

746 / Messing et al.

1 Provigo distribution inc. and Girard Syndicat des travailleuses et travailleurs des magasinsProvigo de Port-Cartier (C.S.N.) and CSST, [1991] C.A.L.P. 539.

could potentially work sitting. Workers were paid $15 for the costs of theirparticipation.

Workers were asked a series of questions based in part on a standard ergo-nomics questionnaire (12), with questions on work schedules, employment status,working postures, access to seats and other working conditions, and sites ofdiscomfort (pain or fatigue) that was experienced very often or all the time andthat interfered with their usual activities for a period of at least three months.The questions on usual working posture and on symptoms were derived from thoseused in the Québec Health Survey (13). If workers had no or limited access toseats, they were asked how they felt about this and what if anything they had doneabout it. They were asked to list the advantages and disadvantages of their usualworking posture. In addition, they were asked about strategies that they had usedor thought about using to prevent and cope with any pain arising from their work,including legal action, changes in work status or place of employment, contactswith a union, and use of medical and paramedical resources. Age, sex, height, andweight were also recorded. Interviewees were encouraged to expand on theiranswers. The interviews lasted from 90 minutes to 2 hours, and were conductedover a six-month period in 2003. Ethical clearance for the study of prolongedstanding was obtained from the Université du Québec à Montréal Comité dedéontologie, and consent forms were signed by all participants.

Interviews were recorded and then transcribed by the interviewer. Interviewtranscripts were subjected to a qualitative content analysis that borrowed fromgrounded theory traditions (14). Based on multiple readings of the data, theanalysis started with coding, which consisted of attaching names to themesemerging from the transcripts, and developing categories that grouped similarthemes. The four authors, including the interviewer, then divided into twogroups. Each group read the interview transcripts, verified how they had beenanalyzed and coded in themes, and refined the coding as well as the names ofthemes and categories. Then the entire team met and synthesized the results of thetwo groups. This process involved winnowing the data and creating a manageableset of themes and categories. The interviewer then recoded all the interviews usingthe final set of themes and categories. Excerpts from the interview transcriptsincluded in the the article were translated into English by the authors, and realnames were replaced by pseudonyms.

RESULTS

Participants and Their Working Conditions

Compared with standing workers in the Québec population (8), participantswere much younger, less senior, more often female, much less often immi-grants, and much more often in small workplaces (Table 1). Thirty percent of

Standing vs. Sitting at Work / 747

1 2 3 4a

5 6b 7b

11 12 13 14a

51 23 17 19 22 26 48 25 22 22 20 18 25 24 25 24

M F F F F M F M F M M M M F M F

17 1.5

17 18a

20 21a

23 24 25b

26 27a,b

47 23 23 21 23 22 30 30 24 54 22 23 23 42 27 23

F F F F F M M M F F F M M F

31 0.4

them were students. Service workers were heavily over-represented, with onlythree interviewees in production jobs. Twenty-one were in direct contact withthe public.

Interviewees worked under relatively precarious conditions. Only 46 percentof them worked full time, and 60 percent had a schedule that varied from dayto day and/or week to week. Median seniority at the present job was 1.5 years.Although most jobs were not formally short-term or seasonal, insecurity aboutkeeping the job was nearly universal, because of anxiety about supervisor evalu-ation, small business survival, or client recruitment. Students seemed as anxiousas others to keep their jobs.

On average, interviewees had worked in a standing occupation for 4.9 years(Table 1). The respondents all reported that they usually worked standing, andmost of them (73 percent) reported that they usually moved short distances(less than five meters) at a time. The rest were restricted to an even smaller area,where they moved only one or two steps. Sixty percent were never allowed tosit, and only two could sit at will. Among the 12 who replied that they could sitat will or occasionally, five nevertheless said that no seat was available at theirworksite (some sat on counters and the like).

All workers but one reported pain or fatigue associated with their workingposture (Table 1). Three-quarters of workers reported discomfort in the lowerlimbs, more than half had symptoms in their feet, and two-thirds in their back.Of the 29 reporting some discomfort, 21 had made some change in their lifestylebecause of it. Eight had bought special shoes. Ten had been absent from work orhad visited a medical professional because of such a problem.

In the context of these working conditions and symptoms, several themesemerged from the interviews, corresponding to reasons given by intervieweesfor wanting or not wanting to change their working posture (see Figure 1).Grouped into four main categories, these reasons are invoked for not wantinga change—minimizing pain and fatigue; seeing standing as positive and changeas negative; relying on individual coping strategies—or for wanting change—considering strategies for meaningful change.

Minimizing Pain and Fatigue

The level of perceived discomfort was high, considering that the populationwas young and had an average self-reported body mass index of just under 23(healthy weight for height). However, few spoke of it as a serious problem, eventhose who had been to a doctor or had had to take sick leave. Only one men-tioned the possibility of long-term health effects. Twenty-one of those whoexperienced discomfort thought it was a normal part of the job, like Corinne,a barmaid, who said, in response to a question about her working posture:“Funny question . . . I don’t know if it’s ‘comfortable.’ . . . Well for sure it isn’t‘comfortable’ but I’m OK with it.”

The seven students and 18 non-students who planned to change jobs were alllooking for better working conditions or higher pay. Only three cited the workingposture and associated fatigue when asked whether they planned to keep theirjob for a long time. Several compared the job favorably with others they hadhad that caused more pain. Few thought the pain was important enough to botherabout, because it went away after a while, because they worked part time, orbecause they could still function. Martine, a food store clerk, described thisas follows: “Everyone hurts. . . . Our feet hurt and we walk all funny [laughs]. . . .We know it goes with what we do. We tend to say if it hurts too much, wellchange jobs!”

Some blamed themselves for the discomfort. Julien said his legs were toothin, Georges described himself as a “weakling” (une petite nature), and Françoisthought it was all in his mind. Roch said he didn’t want it known that he feltpain because people would think he was “foolish.” When asked why they hadn’tdone anything about their pain, they replied that it was a minor pain or a sign ofweakness (males) or laziness (females). Women were more likely to have toldemployers or supervisors about their discomfort and more likely to have askedthem to change the situation. In fact, almost all workers who expressed anyresentment about the working conditions were women. The men were more oftenheard to say that it would be unreasonable to ask to be seated, because of the natureof the work or the design of the workplace.

Working posture was not usually the only or even the most problematicelement of the work situation. Several workers associated pain and fatigue withother aspects of their jobs, such as repetitive movements or mental exhaustion.Five of the interviewees had schedules that did not respect the legal minimumfor rest periods (30 minutes per five-hour period), and many others had verylong workdays. Sylvain worked on his feet in a small kiosk in an amusementpark 60 to 70 hours per week, with no access to seating. His stint ended toolate for him to take public transportation, and he had to walk more than twokilometers to get home.

Seeing Standing as Positive and Change

as Negative

Seven of the men and three of the women thought that standing was the idealposture for their job; the others thought a sit-stand seat or alternating betweenstanding and sitting would be ideal. Of those who thought standing was best,eight thought the job could not be done otherwise or the workplace was notdesigned for sitting work. Bruno also thought the standing position kept himfrom falling asleep on the job. Several, like Lucie, expressed reservations aboutwhat would happen if they sat: “I’m really happy to sit down at lunch, it doesme good, relaxes me, it’s especially my back I think, except I find it hard toget back up. My muscles get cold. . . . So then it really hurts a lot.”

Nineteen of the 21 in contact with the public thought that standing was aquestion of image. Julien, a food service cashier/receptionist, noted this issue:

It’s really a concept, they want to create a really warm atmosphere, theimage . . . you really have to be there for the customer, you have to be smiling,you have to be in a good mood, and you have to be standing [laughs].Sitting, for them, it’s too relaxed, it looks a bit . . . it could make the customerfeel a bit ill at ease.

In those jobs where there was contact with the customer, there could also beconcern lest the customer see them as lazy. Alain, a gas station clerk, worriedabout this: “When I see the cashiers sometimes sitting on milk boxes, and whenthe customer comes in and he is sitting behind the counter . . . and he’s like pickinghis nose . . . well it’s a less attractive image than the other cashier who is activeand doing things in the store.”

In many cases the interviewee identified with the employer’s interests. Corinnedescribed this in detail:

There could be . . . a customer who, let’s say, orders a beer when he has two tothree swallows left. . . . Well then maybe if he sees me sitting, he’ll wait toreally finish his beer instead of ordering another because he’s maybe afraid ofdisturbing me . . . so he feels bad, he extends the time to order his beer, and thebar makes less money. . . . Well he spends less, and I am still there to representthe bar. So there are several aspects that mean that sitting is not really possible.

No workers perceived employers as interested in employees’ comfort, butthey saw them rather as being solely (and legitimately) interested in makingmoney. Only seven of the 20 who thought some sitting would be desirable hadasked the employer for a seat. Martine, the food store clerk, expressed thesentiment of the interviewees: “Even if we asked we wouldn’t get one. It’s a lostcause from the beginning.” Marie, a fruit store cashier, explained, “I don’t thinkthe boss would want to put in one less cash register so that we could have moreroom [for a seat].” Alain, the gas station clerk, said, “I’m not going to go complainto the boss, it wouldn’t change anything much. He’s not going to give me a backrub, so I don’t complain.”

Many ascribed great importance to preserving a good relationship with theemployer, describing the employer as “kind” or “pretty much of a friend.” Asupervisor who allowed them to sit sometimes was “nice,” according to Julien.Corinne, the barmaid, explained: “I’m still free in the positions I can be in, it’snot like the hostess job I had where I didn’t have the right to put my hands inmy pockets. . . . I can lean on the counter in front or put my bottom on the countersat the back.”

It seems, therefore, that asking for a seat is part of a continuing strategydeployed in relation to the employer or supervisor, also involving negotiation of

such conditions as working schedules, pay raises, and problems with colleagues.Requests must not be excessive and not occur too often.

As mentioned above, 54 percent of the interviewees worked part time, andmany were on-call, temporary workers. Very few regarded their jobs as perma-nent; only five of the 30 said they wanted to keep their present job for “a longtime.” Three of these were students, to whom “a long time” meant until theyfinished their studies. Very few of the service workers looked at the job oroccupation as a permanent part of their lives. Yet, in response to a question aboutredesigning the workplace to allow workers to sit, several workers explicitlylinked their reluctance to press for change to employment insecurity. François, aphotocopy clerk, said: “[To allow sitting] they would have to buy more machines,then they would lose money because the machines aren’t used to their capacity.Then they’ll go into bankruptcy, then I’d lose my job.”

None of the workers had thought about involving any other agencies in theirworking conditions, including the 11 who were in unions, although the unions inat least two of the workplaces had succeeded in gaining some changes in seating.In the casino, the union had negotiated frequent sitting breaks. Pierre, who workedthere, thought the union was not interested in prolonged standing any morebecause it had moved on to an interest in repetitive movements. In the liquorstore chain, the union had negotiated seats in all the checkout areas. However, theareas had not been designed for sitting work so the seats were usually notaccessible, and workers were reluctant to sit for fear that the public woulddisapprove. It had not occurred to the liquor store worker that he could ask theunion to intervene about this: “The union is busy doing other things [laughs].”

Relying on Individual Coping Strategies

The back and lower limb pain associated with prolonged standing gave rise to apanoply of individual coping strategies, which are successful to a certain degreeand relieve pressure to change the situation. These can be classed variously asstrategies to prevent pain, to manage pain while working, or to restore themselves

to a pain-free state after work. Individual preventive strategies involved specialshoes, support stockings, standing on anti-fatigue mats, leaning on a counter orother support, fidgeting in place, and putting one leg up on a step or support.Some did exercises that they believed helped prevent pain. Some workers haddeveloped strategies to adapt their work tasks, such as asking to go to the bathroommore often so as to sit or stretch, arranging for task rotation, finding excusesor justifications to work at tasks usually done sitting, or hiding to sit where thesupervisor couldn’t see them. Jacques found excuses to go to the supervisor’soffice to sit and chat with him. Vanessa, a bakery clerk, had several techniques:“I shake my feet, I try to make my legs feel less heavy. . . . You go hide in thebathroom. There’s a mini bathroom, I go there to sit down for two minutes. . . . Youtake a trip to the bathroom, so you can hide from the customers.”

All but a few of the interviewees used various strategies at home to restorethemselves to health and well-being. Most sat and rested after work. Severalhad stopped doing physical exercise after work, due to fatigue or pain, althoughone had tried doing back-strengthening exercises. Many took analgesic or anti-inflammatory pills, used foot spray, or did special exercises. One had consulted achiropractor, one an osteopath, and one a massage therapist. A large majority ofthose who suffered pain shared their experience with colleagues, like Tanya,a medical records clerk:

There are twenty of us. When we go on break, sometimes we sit and “Oh,I really hurt here, oh I’m having a heavy day, my legs hurt.” Or at the endof lunchtime or during the afternoon, when we’re tired we come out of ourfiling area and sit on our little stools and chat, we tell each other we’re tired.

Considering Strategies for Meaningful Change

A comparatively small part of the content of the interviews related to any state-ments to the effect that workers would be interested in pushing for change (bottomof Figure 1). A rough classification showed 878 statements in the “towards thestatus quo” category compared with only 138 in the “towards change” category.Several workers did express their feeling that their situation was unjust. The mostvehement was Élisabeth, who sold sports equipment. At her workplace, theemployer allowed rest breaks only for those workers who smoked, since hehimself was a smoker and understood that they had to have a cigarette from time totime. Thus, only smokers had a chance to sit during the workday. She had oftendiscussed the situation with her fellow non-smoking employees and was defiant insmall ways, although she would not confront her employer. She would sometimestake the opportunity to sit if a column hid her from her boss’s view, and shethought her boss would not fire her because she was more senior than otheremployees. However, even Élisabeth did not want to ask for a seat.

Many other workers also explicitly disagreed with employers’ attitudes towardstanding. However, Jeanne, as assistant head cashier, felt she still had to enforcethe rules: “There are some girls, but we don’t have the right to do that, they’lllean, when no one’s there, just lean their two arms on the counter, really ‘liedown’ to rest. . . . I know they do that because maybe they have a backache,basically because they’re tired, but I have to give them a warning.” Two of theolder women had taken action so they could sit. Carole, a bank teller, describedher futile attempts to get assigned to sitting work with some bitterness. Sheresented the fact that her supervisors sat all day: “For them it’s OK but not forus.” When interviewees did ask for a seat, it could be because others (who wereless visible to the public) had them. Lina, who ran a bookstall in the subway,had rebelled: “I went and got a seat at [a hardware store] next door and I put thebill in the cash. I said to myself, ‘sometimes enough is enough.’”

DISCUSSION

We sought explanations for our results in four areas: age and sex of the studyparticipants; practical problems with sitting; employer-employee relations; andperceptions of pain and suffering.

Age and Sex of Participants

The proportion of students in the interviewed population was somewhat high, dueto our recruitment technique: 22 percent of the Québec working population aged15 to 29 are students (15), compared with the 30 percent among our interviewees.Contrary to our expectation, we found no differences among workers accordingto whether or not they were students. As far as it could be ascertained in such asmall sample, students were as interested as others in retaining their jobs, andas reluctant to complain. Even the two law students seemed to be unaware oftheir rights and uninterested in pursuing any action to sit down. The similarattitudes toward the job among students and non-students could be explainedby the fact that very few workers seemed to regard their jobs as a long-termcommitment, either on their part or that of the employer. The three workerswho had tried the hardest to change their conditions (the hairdresser who hadchanged her work station, the bank teller who had fought for a seat, and thebookseller who had bought a seat and charged it to her employer) were all over 40,and two of them had more than ten years’ seniority.

Young women are a majority in the service occupations with prolongedstanding: 59 percent of sales clerks, 86 percent of cashiers, 88 percent of banktellers, and 79 percent of food servers (16). We have found that most workerswho stand in a relatively static position are women (8). Women have been saidto be particularly disadvantaged in pressing for improvements in the workplace.This is attributed to the attitudes of decision-makers (17, 18) and to neglect byoccupational health professionals and government programs (19, 20). Unions arealso said to be less adequate in defending women’s issues (21). However, the maleinterviewees did not seem to be any more aggressive in pursuing change. In fact,men more often ascribed their pain to personal weakness than did women.

Four explanations are possible for our finding that males did not pursueremedies more vigorously. First, our sample could be atypical; we could haveaccessed too few men. Second, men could be ill at ease complaining aboutpain. Although the literature is not unanimous, researchers have often showedfemales signaling pain more quickly on tests of pain threshold (22, 23), but notin some other contexts (24). Some researchers think women are more willingto express discomfort not associated with an “objective” condition (25). Third,the advantage men have in unions could come from techniques developed inmale-dominated unions that might be harder to use in the service sector unionsexamined in the present study. It might be more difficult to complain about one’s

own pain when one’s job is to serve others, and when employment linksare weaker. Female interviewees more often worked in direct contact with thepublic, where image concerns were paramount. Three of the seven men in directcontact with the public also expressed concern about the image of a seated worker.In fact, the two unions that had negotiated some measures to alleviate pro-longed standing had a male majority among their members, although the studyparticipants from these unions did not seem to be more militant than otherinterviewees. The conditions that enable both women and men to participatein unions and obtain positive effects on health and safety should be furtherinvestigated. Fourth, gender-differentiated visions of male and female bodiesmay make it easier for women to talk about their bodies in the workplace thanfor men. McDowell and Court (26), for example, point out that women areexpected to use their bodies in the workplace, as a tool for attracting customersand putting them at ease.

Practical Problems with Sitting

We must also consider whether the numerous practical problems reported by theinterviewees explain their reluctance to press for change. Is it, in fact, impossibleto sit in many jobs in the service occupations where there is contact with thepublic? This idea seems absurd in the face of evidence from other countries whereworkers at the same jobs are given seats, but it may well be that, due to designconsiderations, it is difficult to sit for any length of time at some jobs in NorthAmerica without rearrangement of the work station. European checkout countersin grocery stores are designed somewhat differently from those in North America,with the counter much lower and a smaller working radius (see, for example, thephotograph of a French supermarket work station; 27). Still, study participantsdescribed many workplaces where small changes in the layout or use of a sit-standchair would have allowed them to sit at least sometimes.

However, employees are likely to find themselves in a situation where theymust ask the employer to spend at least some money and possibly do some extraplanning in order to allow workers to sit. In service occupations, this meansalso dealing with the perceived problems of the image of the seated worker aslazy and unavailable.

It has often been possible to persuade employers, even those in the servicesector, to make changes in the physical surroundings so as to remove risk factors.However, this has often been in situations where the worker is engaged inupper limb activity, such as data entry, that brings a profit or advantage tothe employer (28). Upper limb pain arising from repetitive movements is wellrecognized as a health and safety problem, in part because workers with paincan no longer perform those movements and therefore are absent from theirjobs. In short, workers are usually paid for what they do with their upper limbs,not their lower limbs. Discomfort from prolonged standing rarely keeps the

worker from doing any manipulations required by the job. Therefore the employeemust ask the employer for something that no production imperative can justify.

Employer-Employee Relations

The workers we interviewed see the employer as unconcerned about their welfare(“he’s not going to give me a back rub”), but concerned about client satisfactionand productivity, both of which are linked, in employer’s and employee’s sharedperceptions, to the standing posture. For the interviewees, standing representsavailability to clients. Hochschild (29) and others have discussed employers’ useof the worker’s body (and emotional capacities) to create an impression on theclient, for instance with the smile of the airline flight attendant (29) or thesupermarket cashier (30). The use of the standing position as part of the corporateimage was well described by our interviewee Julien when he said that “it’sreally a concept . . . a warm atmosphere . . . an image.” Lan expresses this as,“When employers buy labor power, they buy not only workers’ potentiality ofconducting physical labor activities, but also their capability to embody certainsymbolic images or messages (31, p. 88). The interviewees in our study seemedto accept the idea that their employer had bought their representation of avail-ability by prolonged standing.

Research has shown that prolonged standing increases with decreasing socio-economic status and is associated with low levels of control over the workenvironment (8). Therefore, it is significant that the interviewees thought theircomfort was not important to employers or clients and that they themselveswere not inclined to give it much importance. Workers essentially said that, ifthey could keep on working and could recover from their workday in a reasonabletime, then there was no reason to expect comfort at work.

Standing also represents hard work as opposed to laziness. Ryan (32) describesa series of prejudices about the working class that suggest that working-classculture makes workers unwilling to work. Management becomes “suspicious,”according to one study participant, if workers are sitting. However, this attitudeseems to be limited to workers in relatively low-status jobs. The bank teller,Carole, pointed this out when referring to the fact that the bank investmentcounselors “but not us” could sit with their clients.

Interviewees seemed to be very reluctant to challenge the employer’s authority.It is possible that interviewees described their discomfort as minor because theydid not want to admit their fear of challenging the employer in order to alleviateit. This may be related to the young age and relatively low social class of mostof them. This is a serious problem, since young workers have a very high rate ofaccidents and injuries (33). Most young workers of both sexes are in a precariousemployment relationship, which is in itself associated with poor occupationalhealth (34). Mustard and colleagues (35) associated low status in the employmenthierarchy with poorer health status. One of the mechanisms by which this decline

could occur is through exposure to unhealthful conditions at work. In principle,the legal system and unions should ensure protection of workers against suchconditions. This is not happening in the case of prolonged standing.

Historians of occupational health have pointed out the difficulties faced byunions in mobilizing the workforce on health issues. Often, bread-and-butterissues have taken precedence over health and safety. Although this phenomenonhas usually been pointed out in relation to male-dominated unions (36, 37),Wigmore (38) has shown that violence against women in the health care sectorhas also been portrayed as “part of the job.” However, workers’ experience of thisprocess has not been well described.

Perceptions of Pain and Suffering

Interviewees did not regard their discomfort as a serious problem, despite theirreports of pain and the many prevention, coping, and curing strategies theydeployed. They described it as normal, expressed uncertainty about its relation totheir working posture, and expected that it would be transitory and, especially,would not interfere with putting in a full workday. Some even thought thatdiscomfort was a positive sign, proof that they were honest, producing a day’swork for a day’s pay.

This disregard for the body has been noted by other authors. Dejours suggeststhat working-class men (at least) are asked to see continuing to work in the faceof suffering as courageous. He emphasizes the current context of downsizingand the push to raise productivity, which renders resistance to employers’ agendaextremely difficult. “Virility is the concept that allows one to raise the misfortuneinflicted on others to the status of a positive value, in the name of labor” (39,p. 191, our translation). Expressing suffering or changing some aspect of workperformance in response to it would, on the contrary, be thought of as spineless,and the worker would lose respect for himself. For Andrieux (40) as well,pain-related behaviors are linked to social class. For the working class, individualhealth is not a major concern. Workers in pain will turn inward rather than admittheir pain to an authority, whether employer or doctor.

Laberge and Sankoff (41) have used the term body habitus to refer to Bourdieu’s(42) concept of relation to the body. Both Bourdieu (in France) and Laberge andSankoff (in Canada) have found differences among the various social classes interms of their habitus. They have shown how individuals from the more privilegedclasses view the body as an end product, which leads to an emphasis on healthor on personal appearance. In contrast, it has been demonstrated that individualsfrom the working classes have an instrumental relation to the body, where thebody is seen as a means to an end. For example, “making the body well” is seenprimarily as a means of returning to work (42).

Le Breton (43) suggests that the working-class values of resistance to fatigueand pain and of neglecting health, linked to the Judeo-Christian tradition, are

becoming attenuated as work organization has changed in recent years. Wehave not seen evidence of this. On the contrary, in our study, almost all thecontent of the workers’ interviews tended to support the status quo, with anemphasis on individual responsibility for production. However, we do not seethis deprecation of pain as evidence that workers would not welcome somekind of collective intervention strategy. In fact, we see their use of a varietyof individual strategies as active participation in efforts to improve their livesat work. Social policy, however, has so far not been a useful complement tothese efforts.

We are not yet able to predict what would inspire workers to protest the standingposition. We note that the two workplaces where collective action had beentaken shared some characteristics: they were publicly owned, run by government-owned corporations, prosperous, unionized, and with a relatively well-paid,predominantly male workforce. Interviewees in these two jobs were amongthose with the longest rest breaks. This led us to wonder whether seating is aluxury item that is negotiated after job security, salary, and minimal workingconditions have been achieved. But even in these workplaces, workers did notfeel free to sit in the presence of clients. It would be interesting to find outwhether this reluctance to sit arises from some representation of social classfound in North America but not in other parts of the world.

CONCLUSIONS

Workers who stand all day are lower-status workers with little ability to exertpressure on employers. On the contrary, they wish to impress the employer withtheir honesty and productivity. They may perceive their job as temporary andwould rather leave (or dream of leaving) than try to transform it, even though theirnew job may also involve many of the same characteristics. Other aspects ofthe job such as salary and schedules seem to be of much more importancethan discomfort. Unfortunately, prolonged standing may have a lasting effect onphysical health, and the lack of respect associated with an insistence on standingmay affect their psychological health.

Immediate solutions are being sought by working with the relevant unions torecognize the problem and to help empower workers. Conditions in non-unionizedworkplaces could then be expected to improve. More generally, we hope tosensitize the population of Québec to the difficulties associated with prolongedstanding, in order to arrive at a consensus to end needless suffering.

The present research suggests some avenues to explore. However, we inter-viewed only workers and had no access to the opinions of others in theworkplace. Questions should also be asked of the other players in this process:employers, unions, and health and safety authorities. In addition, it would beinteresting to do a cross-cultural study to explore the roots of attitudes toward

inter-class relationships and prolonged standing at work in European, Asian,African, and Latin American cultures.

Acknowledgments — We thank the workers involved for their participation. Weare grateful to Professors Katherine Lippel, Nicole Vézina, Patrizia Romito, andSusan Stock for helpful conversations. The study was supported by grants fromthe Social Sciences and Humanities Research Council of Canada and the Fondsquébecois de recherche sur la société et la culture. Some preliminary results fromthis study were reported in the French-language journal Travail Genre et Sociétés.

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Direct reprint requests to:

Dr. Karen MessingCINBIOSEUniversité du Québec à MontréalC.P. 8888, Succursale Centre-villeMontréal, Québec H3C 3P8Canada

e-mail: messing.karen@uqam.ca

STANDING STILL: WHY NORTH AMERICAN WORKERS ARE NOT INSISTING ON SEATS DESPITE KNOWN HEALTH BENEFITS

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